Will swelling from a facelift and fat transfer performed at the same time cause loose skin?

A deep face and neck lift addresses sagging skin, muscle laxity, and underlying structural changes, providing a more youthful and lifted appearance. Fat grafting, on the other hand, is often used to restore volume to areas that have lost fat, such as the cheeks, under the eyes, or around the jawline. By performing both procedures in the same stage, we can achieve a more harmonious and natural-looking result, as the lifting of the skin and tissues from the facelift creates a better foundation for fat transfer.
Combining these procedures can also help to reduce the overall recovery time, as you're only undergoing one surgery and anesthesia session, rather than two separate ones. Additionally, it allows us to assess and sculpt the face more comprehensively, ensuring the fat is strategically placed to enhance the contours and balance of your facial features.
MD Erman Ak

Facelift and fat transfer procedures are often performed together to achieve comprehensive facial rejuvenation. Postoperative swelling is a normal part of the healing process for both procedures. Swelling typically peaks within the first few days and gradually subsides over several weeks to months, depending on the extent of the procedures and individual healing responses.
Swelling itself does not cause loose skin. On the contrary, a well-performed facelift tightens the skin and underlying tissues, and the fat transfer helps restore volume. However, factors such as skin elasticity, the amount of redundant skin before the surgery, and how the body responds to healing can affect the final results. In some cases, if the skin's elasticity is already significantly compromised, there might be a need for additional skin tightening or adjustment over time.
Proper post-surgical care and follow-up consultations with your plastic surgeon are essential to monitor healing and ensure optimal results.

Many patients are concerned with having too many procedures all at once and the recovery period. I commonly combine fat transfer with my facelift and blepharoplasty procedures without a concern. There will be slightly more swelling having the procedures performed together, but it shouldn't be a degree of swelling that will compromise your long term result. I would also discuss with your surgeon the amount of fat transfer that will be performed. Historically, many surgeons performed extremely large volume of fat transfer (over 100 cc to the face) and this could cause significant prolonged swelling. I recommend smaller volumes of fat transfer with my deep plane facelift procedures. I feel the facelift should do most of the rejuvenation and the fat transfer just creates subtle volume enhancement.

Hello, hope you are well. These procedures can be done safely and effectively together--I do this routinely. Generally speaking, the swelling that occurs after surgery does not impact the placement of transferred fat. Nor does it cause skin to stretch and sag, as you describe in your concerns. Good luck!

Best,
Dr. Tower

It's generally recommended to wait about 6 to 12 weeks after a facelift before undergoing additional procedures like liposuction and a breast lift. This allows ample time for initial healing and reduces the risk of complications. However, your specific recovery timeline may vary, so consult with both your facelift surgeon and the surgeons performing the lipo and breast lift to get personalized advice based on your individual healing progress.

Generally speaking, this is not of particular concern. Your skin will naturally contracy from the tightening and scarring following the procedure eliminating much of the dead space you may be concerned about creating with the concomitant fat grafting. Furthermore, the grafting fat is thought to have stem cells and other factors that will itself tighten the skin. These two procedures are commonly performed together with excellent results and no concerns of loose skin following the procedure.

Fat transfers done at the same time as a facelift will not cause loose skin. However, many surgeons prefer to do the fat transfers later to see what area needs it and it may be safer to place a larger volume of fat at a later time.

Best Wishes,

Gary Horndeski, M.D.

many surgeons perform facial fat grafting as a routine part of face/neck lifts. Volumes vary, but often will be somewhere betweeen 15-25cc of fat. This volume is added in targeted areas of deeper fat compartments and should not drastically affect your post-operative swelling or have a long-term affect on the facelift.

It’s very common for plastic surgeons to perform fat grafting in conjunction with a facelift.
I can’t tell you what percentage of plastic surgeons do this routinely but my best guess is at least half of plastic surgeons today will rely on using grafting fat in conjunction with a facelift.
Doing this will not cause your skin to be stretched out.
In regards to decision making I suggest focusing your efforts on provider selection has been by far the most important variable.
Once you find the right provider simply follow their recommendation.
Facial fat transfer is by its very nature somewhat unpredictable and it’s generally better to graft conservatively understanding a follow up procedure may be indicated.
For that reason grafting, some fat in conjunction with the facelift would be ideal understanding that a second round of fat transfer is sometimes needed to get the best outcome.
Knowing that your surgeon has experience with both procedures is in the end what’s most important.
Finding the right provider is not easy or straightforward, but is inevitably the most important decision.I generally recommend patients have multiple consultations before selecting a provider.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar characteristics to your own.
If you’re concerned about the outcome of fat transfer, then ask them to show you examples of patients who just had facial fat transfer.
There is nothing inherently wrong with doing a fat transfer in conjunction with the facelift.
Many plastic surgeons would say it is an ideal combination.
Final outcomes are usually based on two variables.
The first is the patient’s candidacy for the procedure in the first place and the second is the skill of the provider.
There isn’t much patience can do regarding their own candidacy. What patients do you have control over is provider selection so focus your efforts on the variable that has the greatest impact and is most important.
Best,
Mats Hagstrom MD